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使用乙酰唑胺负荷 SPECT 测量脑血管储备能力预测总运动功能结局。

The prediction of gross motor outcome using cerebrovascular reserve measured by acetazolamide-challenged SPECT.

机构信息

Department of Nuclear Medicine, Institute of Wonkwang Medical Science, Wonkwang University College of Medicine and Hospital, Iksan, Korea.

出版信息

NeuroRehabilitation. 2012;30(4):359-67. doi: 10.3233/NRE-2012-0767.

Abstract

The purpose of this study was to evaluate the relationship between the recovery of gross motor function and cerebrovascular reserve (CVR) capacity measured by brain perfusion single-photon emission computed tomography (SPECT) in patients with first-ever supratentorial infarction. Gross motor function was assessed according to the locomotor and mobility subset of the functional independence measure. The CVR was measured as the difference in the regional cerebral blood flow (rCBF) after acetazolamide (ACZ)-challenged(99m)Tc-ECD perfusion SPECT from baseline rCBF. All 22 hemiplegic patients (mean age, 60.97 years) enrolled were admitted at a mean of 20.86 days from onset and received rehabilitation care for an average of 38.82 days. The recovery of gross motor function was significantly correlated with baseline rCBF and CVR of ACZ-SPECT in the areas of affected supratentorial hemisphere (r=0.447 and r=0.444, respectively, p < 0.05). Analysis of the linear regression model, adjusted for time to SPECT testing, revealed that the CVR in the affected supratentorial hemisphere was a significant predictor of the gross motor outcome (p< 0.05). In conclusion, the CVR of the affected supratentorial hemisphere may be employed along with other parameters to predict the gross motor recovery of patients with subacute infarction.

摘要

本研究旨在评估首次幕上梗死患者的总体运动功能恢复与脑灌注单光子发射计算机断层扫描(SPECT)测量的脑血管储备(CVR)能力之间的关系。总体运动功能根据功能独立性测量的运动和移动子集中的内容进行评估。CVR 通过乙酰唑胺(ACZ)挑战后(99m)Tc-ECD 灌注 SPECT 与基线 rCBF 的区域脑血流(rCBF)差异来测量。所有 22 名偏瘫患者(平均年龄 60.97 岁)均在发病后平均 20.86 天入院,并接受平均 38.82 天的康复护理。总体运动功能的恢复与受影响的幕上半球的基线 rCBF 和 ACZ-SPECT 的 CVR 呈显著相关(r=0.447 和 r=0.444,分别为 p<0.05)。对 SPECT 检测时间进行调整的线性回归模型分析显示,受影响的幕上半球的 CVR 是总体运动结果的重要预测因素(p<0.05)。总之,受影响的幕上半球的 CVR 可能与其他参数一起用于预测亚急性梗死患者的总体运动恢复。

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